Expressing and storing breastmilk

Naturally the best way to remove milk from your breast is by feeding your baby, but there may be occasions when this is not possible and you need to express your milk.

Perhaps

• your baby is premature or unable to suck well
• your baby is in hospital and you can't be there for every feed
• you are in hospital and your baby can't be there for every feed
• you have returned to the paid work force, study or other commitments
• you are leaving your baby with a sitter while you are out, or
• your breasts sometimes feel too full and uncomfortable.

Many mothers like to keep a small store of breastmilk in the freezer for emergencies, as babies fed breastmilk alone during the first six months are less likely to suffer allergies or infective diseases.

There are several techniques you can use to encourage your milk to let down while expressing.

• Consciously try to relax, using whatever method suits you. Try to express in a quiet, warm, relaxing area, away from distractions. While expressing, breathe slowly and deeply. You could express in the place you usually sit to feed. Some mothers have a warm drink first or listen to soft music such as ABA's relaxation tape Softly Softly, relaxing to breastfeed. Warmth (expressing after a warm shower, warm face washers on the breast for a few minutes before starting) may also help.
• Gently massaging your breasts by stroking down towards the nipple, and gently rolling the nipples between your fingers. While you can't actually push the milk out of your breasts by massage, you can help trigger the let-down by touching your breasts.
• Thinking about your baby and how much your breastmilk is helping her will encourage your let-down reflex. If she is premature or sick in hospital,you might find it easier to express near her crib or just after you leave her. If you are away from her, try looking at her photo to help you let down.
• Having someone support you. Many mothers find they manage much better when they have an encouraging partner or friend. Your ABA breastfeeding counsellor can also give you ideas and encouragement as you learn to express.

Expressing and Storing Breastmilk, one of 27 booklets written by the Australian Breastfeeding Association, covers everything you need to know about expressing: how the milk lets down, hygiene, photos of how to hand express, discussion on how to use different types of breast pump, what to store the milk in and for how long, and how to clean your pump and containers. Other topics are thawing breastmilk, transporting breastmilk, and cup feeding. Booklets can be purchased from Mothers Direct.

How much you need to express depends on your reason for expressing. If it is to reduce engorgement when you have too much milk, you need only express enough to feel comfortable. If you have a blocked duct or mastitis, allow baby to feed as often as possible and express as much as you can after a feed. See ABA's booklet Breast and Nipple Care. Some mothers who are expressing regularly can quickly get 90 - 120ml from both breasts every three to four hours. Others simply cannot express such big volumes at one time, and find it easier to express small amounts more frequently eg up to 30ml every one to two hours. A few mothers find it difficult to express, although they have a good supply and the baby is thriving.

It is important not to judge overall milk production by the amount of milk you can express. The baby's technique of extracting the milk is the optimum, and he will always be able to get more milk than you; expressing is second best.

Hand expressing might not be easy when you first try it - you might feel quite discouraged if, after all your efforts, you only manage a few ml or even a few drops! Take heart, gradually you will become more familiar with the feel of your breasts and how to make the milk flow most easily. When you are able to put your baby to the breast, you will find your supply quickly increases to meet his needs.

Storage of Breastmilk for home use *

Breastmilk	Room Temperature	Refrigerator	Freezer
Freshly expressed into a closed container	6–8 hrs (26ºC or lower). If refrigeration is available store milk there	3–5 days (4ºC or lower) Store in back of refrigerator where it is coldest	2 weeks in freezer compartment inside refrigerator. 3 months in freezer section of refrigerator with separate door. 6–12 months in deep freeze (-18ºC or lower).
Previously frozen— thawed in refrigerator but not warmed	4 hours or less (ie the next feeding)	Store in refrigerator 24 hours	Do not refreeze
Thawed outside refrigerator in warm water	For completion of feeding	Hold for 4 hours or until next feeding	Do not refreeze
Infant has begun feeding	Only for completion of feeding, then discard	Discard	Discard

* Australian Dietary Guidelines for Children and Adolescents - table. Copyright Commonwealth of Australia reproduced by permission

http://www.breastfeeding.asn.au/bfinfo/express.html